Provider Demographics
NPI:1811604564
Name:KENDRICKS, OILEANER F
Entity type:Individual
Prefix:MS
First Name:OILEANER
Middle Name:F
Last Name:KENDRICKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6511 JOYCE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71302-2223
Mailing Address - Country:US
Mailing Address - Phone:318-709-2784
Mailing Address - Fax:
Practice Address - Street 1:6511 JOYCE ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71302-2223
Practice Address - Country:US
Practice Address - Phone:318-709-2784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA228727251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health